05D2204647 CLIA NUMBER - LA CASA MEDICAL HEALTH REHABILITATION CENTER

Laboratory Demographics

CLIA Code: 05D2204647
Facility Name: LA CASA MEDICAL HEALTH REHABILITATION CENTER
Facility Address: 6060 NORTH PARAMOUNT BLVD
LONG BEACH, CA
ZIP 90805
Facility Phone: 562 634-9534
Facility Type: Other - MENTAL HEALTH REHAB
Facility Type: Waiver
Lab Director: DESAGANI KISHORE
NPI Number: 1568550390
Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness

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CLIA Record

Field Name	Field Value
CLIA Number	05D2204647
LAB Type	Other - MENTAL HEALTH REHAB
Facility Name	LA CASA MEDICAL HEALTH REHABILITATION CENTER
Street	6060 NORTH PARAMOUNT BLVD
City	LONG BEACH
State	CA
ZIP	90805
Phone	562 634-9534
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	12/9/2024
Certificate Expiration Date	12/8/2026
Facility Type	Other - MENTAL HEALTH REHAB
Lab Director	DESAGANI KISHORE

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This page was last updated on: 9/29/2025